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USMLE Step 1 Biostatistics & Epidemiology/Population Health practice questions

Study design, test characteristics, bias, and the statistics questions every Step 1 taker dreads. This category has 64 original questions in the full StepExamPrep bank — here are 3 samples with complete explanations.

Sample question 1

A case-control study of a rare cancer relies on patients recalling their past dietary habits from many years ago. Cases, having been diagnosed, may recall past dietary exposures differently than healthy controls. Which type of bias does this describe?

A. Selection bias
B. Recall bias Correct
C. Lead-time bias
D. Confounding
E. Length-time bias
Explanation:

Recall bias occurs when cases (who have a strong motivation to reflect on possible causes of their disease) remember past exposures differently — often more thoroughly — than healthy controls, distorting the observed association; this is a classic limitation of case-control studies relying on retrospective recall.

Sample question 2

In a normally distributed dataset, approximately what percentage of values fall within 2 standard deviations of the mean?

A. 50%
B. 68%
C. 95% Correct
D. 99.7%
E. 100%
Explanation:

In a normal distribution, approximately 95% of values fall within 2 standard deviations of the mean.

Sample question 3

Which of the following best describes the principle of "justice" as outlined in the Belmont Report?

A. Maximizing benefit and minimizing harm to research subjects
B. Respecting individual autonomy and obtaining informed consent
C. Fair distribution of the risks and benefits of research across different populations Correct
D. Ensuring statistical significance in all trial results
E. Guaranteeing a cure for all study participants
Explanation:

Justice, as a Belmont Report principle, specifically concerns the FAIR distribution of research risks and benefits, ensuring no population is unfairly burdened or excluded from potential benefits.

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